Provider Demographics
NPI:1427160209
Name:PRIMARY CARE AMBULANCE CORP
Entity type:Organization
Organization Name:PRIMARY CARE AMBULANCE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-351-7012
Mailing Address - Street 1:237 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-4236
Mailing Address - Country:US
Mailing Address - Phone:718-795-0600
Mailing Address - Fax:718-266-4343
Practice Address - Street 1:84 GRANITE AVE STE K
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10303-2745
Practice Address - Country:US
Practice Address - Phone:718-351-7012
Practice Address - Fax:718-351-7068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY06763416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02338672Medicaid
NYA53221Medicare PIN